Time Proven vs. "New and Improved"

Whenever someone posts about a new clinical or management skill, one will inevitably see a response that says something like: “I’ve done it this way for 25 years and it works perfectly. I don’t need a new way of doing it.” I know clinicians who have said to me, point blank: “I would never do clear aligner therapy. It’s inferior to traditional braces and wires. If that’s what a patient wants, I tell them they’ll need to see a different orthodontist.” I’ve also known clinicians who’ve told me that they would NEVER do any sort of headgear on a patient because there’s no longer a need due to new technology.
Obviously, one doesn’t have to take an all or nothing approach, but how does one decide when and how to test new treatment modalities?
Are using only time-proven, tested and reliable ways of doing things an acceptable approach for our practices, or do we have a responsibility to always try and push the limits and learn new techniques that might shorten treatment time or give a better outcome, if it’s a possibility?
It’s also about our bottom lines, isn’t it? If we can get the same clinical outcome, but less expensively, do we have an obligation to try it? Remember the old saying: “No money, no mission.” A better bottom line is better for you AND the patient, isn’t it?
Imagine you went to a two-day course and saw a new approach/technology/procedure. The speaker showed you dozens of cases, all with what appeared to be beautiful outcomes. The biological and mechanical considerations make sense. What next? Do you just jump on board and start using it, do you use it on selected cases, or do you wait for your friends to try it and pick their brain on social media Moreover,  what is the algorithm that drives us to bring new technology or techniques into our practices?
I guess the question is this: If you’re still doing things exactly as you might have 25 years ago, but getting great results, do you need to change? You’ve shunned CBCTs for your trusted Panorex. You use the same brackets and wire sequence that you started using when you left residency. You refer your soft tissue modifications to a periodontist instead of having a laser. You don’t use tads, instead finding creative solutions to anchorage challenges. You don’t do clear aligner therapy.  You still use alginate instead of intraoral scanners.
But your patients love you, you’re getting amazing results and your overhead is at 40%. Do you really need to change the way you’re doing things? Sure, you might see more on a CBCT, maybe your treatment times are longer, and maybe you feel left out of the technological discussions on social media forums, but you’re comfortable and can show great results.
This isn’t about whether we all have a right to practice the way we want. Of course we do. If you want to us J-pull headgear for every one of your patients, you have that right. But, do we have an obligation to investigate any technique and approach that speeds up treatment (and possible increase overhead)? If what we’ve been doing works, do we have an obligation to look for better? And if the answer is no, is it fair to simply say that the market will choose for us; Patients will simply begin to realize who is up to date and better and who isn’t, right? Does newer necessarily mean better and after all, can we really trust the public to determine what’s “best” for them?
I don’t know the answers to these questions. What I do know is that one of the things that gets me excited about orthodontics is the horizon filled with new technological innovations that seem to lead to an easier, quicker, healthier outcome for my patients. I , too, struggle with the idea of balancing overhead with outcomes, and believing some of what I see. I need to manage the dream with the science and determine what really works and is in my comfort zone and what isn’t.
When I was a restorative dentist, I had two decades of experience to slowly turn my ship in the direction it was headed. I was proud of the fact that my newer technological decisions were rooted in the foundation of science that helped me achieve great outcomes. However, even when I fancied myself on the “cutting edge” I always felt like I was falling behind those who were one step ahead of me. But I never felt the pressure to introduce technology that I didn’t feel was in my patient’s best interests.
In his book, The Singularity is Near, Ray Kurzweil explains:  “Technology goes beyond mere tool making; it is a process of creating ever more powerful technology using the tools from the previous round of innovation.”  This means that new technology is coming at us faster than ever before. We each need to be ready to determine how and why we will utilize it in our practices and be honest with the results we’re getting.
Best wishes,
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If you want to come to learn more about an amazing business meeting for orthodontists, simply visit OP2018.com . We’ve got a world-class lineup of speakers, amazing food and an ambiance that will make you want to come back year after year. You can always email me at Glenn@OrthopreneursRD.com or message me on Facebook. I’m here to help.
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